People have all sorts of excuses for not flossing their teeth. But dentists say there are easy ways to floss that address every excuse. Do you floss? Or, like many people, do you always seem to find a reason not to?

A 2008 survey found that only 49% of Americans floss daily, and 10% never floss. That’s most unfortunate, dentists say, because flossing is even more important than brushing when it comes to preventing periodontal (gum) disease and tooth loss.

Excuse #1: Food doesn’t get caught between my teeth, so I don’t need to floss.

Flossing isn’t so much about removing food debris as it is about removing dental plaque, the complex bacterial ecosystem that forms on tooth surfaces between cleanings. Plaque is what causes tooth decay, inflamed gums (gingivitis), periodontal disease, and eventually tooth loss. Flossing or using an interdental cleaner is the only effective way to remove plaque between teeth.

Start with about 18 inches of floss. Wrap most of it around the middle finger of one hand, the rest around the other middle finger.

Grasp the floss tightly between your thumbs and forefingers, and use a gentle shoeshine motion to guide it between teeth.

When the floss reaches the gum line, form a C shape to follow the contours of the tooth.

Hold the floss firmly against the tooth, and move the floss gently up and down.

Repeat with the other tooth, and then repeat the entire process with the rest of your teeth, “unspooling” fresh sections of floss as you go along.

Don’t forget to floss the backs of your last molars. By far, most gum disease and most decay occurs in the back teeth.

Excuse #3: I’m not coordinated enough to floss.

Many tooth-cleaning options exist for people whose manual dexterity is compromised by poor coordination, hand pain, paralysis, and amputations — or simply by fingers that are too big to fit inside the mouth.

One option is to use floss holders. These disposable plastic Y-shaped devices (some equipped with a spool of floss) hold a span of floss between two prongs to allow one-handed use.

Another option is to forgo floss and clean between teeth using disposable toothpick-like dental stimulators (Stim-U-Dents, Soft-Picks, and so on); narrow spiral brushes (interproximal brushes); or the conical rubber nubs (tip stimulators) found at the end of many toothbrushes or mounted on their own handles.

Excuse #4: I don’t have time to floss.

Effective flossing does take a while — once a day for a good three to five minutes. But even 60 seconds of flossing is of enormous benefit. As with exercise, bathing, and other daily activities, the key is to make flossing a habit. If you make time for your personal hygiene, you can find time to make for flossing, keep floss in plain view, alongside your toothbrush and toothpaste. If you’re too tired to floss before bed, floss in the morning or afternoon. Or keep floss on hand and use it when you find the time.

Excuse #5: It hurts when I floss.

If flossing causes gum pain or bleeding, odds are you have gingivitis or gum disease — precisely the conditions for which flossing is beneficial. Flossing should not be a painful experience. But stopping flossing because of bleeding is just the opposite of what you should be doing.” The good news? With daily brushing, flossing, and rinsing, gum pain and bleeding should stop within a week or two. If either persists, see a dentist.

Excuse #6: My teeth are spaced too close together to floss.

If unwaxed floss doesn’t work for your teeth, you might try waxed floss or floss made of super-slippery polytetrafluoroethylene.

If the spacing between your teeth varies (or if you have significant gum recession), yarn-like “superfloss” may be a good bet. It stretches thin for narrow spaces and fluffs out to clean between teeth that are more widely spaced.

If you’re having trouble finding a workable floss or interdental cleaner on your own, your dentist should be able to offer guidance — and may even offer free samples.

Excuse #7: The floss keeps shredding.

In many cases, broken or fraying floss is caused by a cavity or a problem with dental work — often a broken or poorly fabricated filling or crown. Consult your dentist.

Excuse #8: I have dental work that makes flossing impossible.

Try floss threaders. These monofilament loops make it easy to position floss around dental work.

Why should I floss?

Floss removes plaque and debris that adhere to teeth and gums in between teeth, polishes tooth surfaces and controls bad breath. By flossing your teeth daily, you increase the chances of keeping your teeth a lifetime and decrease your chance of having periodontal (gum) disease and tooth decay. Flossing is the single most important weapon against plaque, perhaps more important than the toothbrush. A toothbrush cleans the tops and sides of your teeth. Dental floss cleans between them. Some people use waterpicks, but floss is the best choice. Many people just don’t spend enough time flossing and many have never been taught to floss properly. When you visit your dentist or hygienist, ask to be shown.

Which type of floss should I use?

Dental floss comes in many forms: waxed and unwaxed, flavored and unflavored, wide and regular. Wide floss, or dental tape, may be helpful for people with a lot of bridge work. Tapes are usually recommended when the spaces between teeth are wide. They all clean and remove plaque about the same. Waxed floss might be easier to slide between tight teeth or tight restorations. However, the unwaxed floss makes a squeaking sound to let you know your teeth are clean. Bonded unwaxed floss does not fray as easily as regular unwaxed floss but does tear more than waxed floss.

How should I floss?

There are two flossing methods: the spool method and the loop method. The spool method is suited for those with manual dexterity. Take an 18-inch piece of floss and wind the bulk of the floss lightly around the middle finger. (Don’t cut off your finger’s circulation!) Wind the rest of the floss similarly around the same finger of the opposite hand. This finger takes up the floss as it becomes soiled or frayed. Maneuver the floss between teeth with your index fingers and thumbs. Don’t pull it down hard against your gums or you will hurt them. Don’t rub it side to side as if you’re shining shoes. Bring the floss up and down several times, forming a “C” shape around the tooth and being sure to go below the gumline. The loop method is suited for children or adults with less nimble hands, poor muscular coordination or arthritis. Take an 18-inch piece of floss and make it into a circle. Tie it securely with three knots. Place all of the fingers, except the thumb, within the loop. Use your index fingers to guide the floss through the lower teeth, and use your thumbs to guide the floss through the upper teeth, going below the gumline and forming a “C” on the side of the tooth.

How often should I floss?

At least once a day. To give your teeth a good flossing, spend at least two or three minutes.

What are floss holders?

You may prefer a prethreaded flosser or floss holder, which often looks like a little hacksaw. Flossers are handy for people with limited dexterity, for those who are just beginning to floss or for caretakers who are flossing someone else’s teeth.

Is it safe to use toothpicks?

In a pinch, toothpicks are effective at removing food between teeth, but for daily cleaning of plaque between teeth, floss is recommended. When you use a toothpick, don’t press too hard, as you can break off the end and lodge it in your gums.

Do I need a waterpick (irrigating device)?

Don’t use waterpicks as a substitute for brushing and flossing. But they are effective around orthodontic braces, which retain food in areas where a toothbrush cannot reach. However, they do not remove plaque. Waterpicks are frequently recommended by dentists for persons with gum disease; solutions containing antibacterial agents like chlorhexidine or tetracycline, available through a dentist’s prescription, can be added to the reservoir in these cases.

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